Fixation-based surgery: A new technique for distal radius osteotomy

Abstract

Fixation-based surgery is a new technique for achieving difficult corrections in some orthopedic procedures. The method is premised on using a fixation device, such as a fracture-fixation plate, during the alignment and distration phases of an open-wedge osteotomy. The basic idea is similar to assembly of manufactured components: pilot holes are drilled in the bone fragments, the fixation plate is attached to one fragment and, when the fragment is moved, the alignment has been achieved when the pilot holes in one fragment line up with predetermined through holes in the fixation plate. The method has been specifically developed to address osteotomy of the distal radius to correct a malunited fracture. The method has been validated in laboratory studies. Clinical trials suggest that the method is no slower than the conventional technique, there is almost no intraoperative X-ray exposure, and that exceptionally large corrections can easily be achieved.